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SYNERGY REVITALIZE MEDICAL CENTER LLC NPI 1558006957


NPI Information

NPI: 1558006957
Provider Name: SYNERGY REVITALIZE MEDICAL CENTER, LLC

Doing Business As: SYNERGY REVITALIZE MED & SPA CENTER

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
5457 TWIN KNOLLS RD STE 300-S11
COLUMBIA, MD
ZIP 21045
Phone: (216) 357-8977
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SYNERGY REVITALIZE MEDICAL CENTER, LLC is an internal medicine in Columbia, MD. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SYNERGY REVITALIZE MEDICAL CENTER, LLC NPI is 1558006957. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Synergy Revitalize Med & Spa Center.

The provider's business location address is:

5457 TWIN KNOLLS RD STE 300-S11
COLUMBIA, MD
ZIP 21045-259
Phone: (216) 357-8977

The provider's authorized official is Elaine M Taylor .
The authorized official title is Ceo and has the following contact phone number (216) 357-8977.

The enumeration date for this NPI number is 4/29/2022 and was last updated on 6/30/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseNo
2207RG0300XInternal MedicineGeriatric MedicineNo
3363LG0600XNurse PractitionerGerontologyNo
4363LP2300XNurse PractitionerPrimary CareNo
5363LA2200XNurse PractitionerAdult HealthNo
6207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1598055100MEDICAIDMARYLAND
21295045755OTHERMASSACHUSETTSNPPES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.